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Gastroenteritis (stomach flu): symptoms, causes, and treatment – Gastroenteritis

Gastroenteritis is a ubiquitous illness with mild to severe manifestations. Recognizing its causes and risk factors will help you prevent it.

The symptoms of these diseases are very bothering; however, most of the people pass over them because of their transitory nature. What should be known is that they could even stay way longer or prompt complications in many cases, as we will see further. I will guide you through this article for you to obtain insights into the doctor’s knowledge about gastroenteritis.

What is the gastrointestinal tract?

First, it is essential to show you what structures I would be referring to throughout this article. The gastrointestinal tract starts on the mouth, continues with the esophagus, stomach, small and large intestine, for then ending in the anus. What you need to understand is that this condition affects the whole track, the stomach, and the intestines on the contrary to diarrhea, where the stomach hardly participates.

This tract participates in the necessary process of food ingestion and water absorbing. Therefore, comestibles play a significant role here, causing symptoms of both upper and lower digestive structures, as the stomach and intestines, correspondingly. The halting of the normal digestive functions ends on unprocessed food and increased quantities of water in the intestinal passage, that would prompt diarrhea or even natural reflexes for cleaning the body as vomit.

File:Digestive system diagram en.svg
Gastrointestinal tract
Attribution to: LadyofHats / Public domain

What is acute gastroenteritis

Gastroenteritis is an overall inflammation of all the digestive structures such as stomach and small and large bowel. It would depend on the length of the disease the forename that it would have as it can be acute gastroenteritis with less than fourteen days or persistent, and chronic gastroenteritis if the duration is more than fourteen and twenty-nine days correspondingly.

In this article, I am going to focus on acute gastroenteritis because it is the most common. In fact, it is one of the most prevalent infectious diseases in the United States and of significant mortality worldwide, mostly in developing countries. The reason why acute gastroenteritis causes death is due to habitual complications that with education are totally preventable.

What is stomach flu then?

It is a term the people use for referring to gastroenteritis, and it is in no relation with the flu, disease by the influenza virus. This situation could confuse the reader because both gastroenteritis and the flu, are sourced in viruses. However, gastroenteritis could have many other triggers, including bacteria, while the flu is mainly by a unique virus, and it is a respiratory disease.

Other terms people use for referring gastroenteritis are stomach bug and food poisoning. And a vast majority of these cases are by norovirus. However, there is an extensive list of possibilities.

What is the difference between diarrhea and this condition?

The symptoms may be the same; however, there are subtle but significant differences between these diseases. Diarrhea is an inflammation of both intestines for whatever cause, including infection. While it could have nausea and vomits, they are not always symptoms, as it is watery diarrhea or loose stool. On the contrary acute gastroenteritis is an inflammation of the whole tract, including the stomach, so nearly always includes symptoms as nausea and vomit.

It is a problem that for both conditions, the causes are nearly the same. Also, they both are foodborne illnesses, in which the infection is the predominant cause. So the idea you must take home is that diarrhea symptoms mostly involve defecation alterations. At the same time, acute gastroenteritis causes a condition in which nausea and vomiting play the leading role.

What causes it?

Infectious gastroenteritis is the most common cause, and it can be by viral, bacteria, or parasites microorganisms. From them, viral gastroenteritis is the vast majority of the cases, followed by bacterial gastroenteritis.

Of course, there are other possibilities of acquiring gastroenteritis, mostly by sterile inflammation, without infection. This cause includes the type of diet, inflammatory bowel disease, incapability of absorbing specific food (lactose intolerance), among others, but they are not as common as the infectious origin.

The viral infection can be by several viruses, although some of them are more frequent than the others, as we will see. Viral gastroenteritis by two viruses, rotavirus, and norovirus, cause nearly all the cases. The rotavirus infection mainly affects the children and causes severe dehydration, although, with the initiation of the rotavirus vaccine, these numbers have seen a decrease. The norovirus infection affects people of all ages, and in relationship with the gastroenteritis outbreaks in crowded and closed settings. Other viruses are also linked to gastroenteritis, albeit less than rotavirus and norovirus, such as calicivirus, astrovirus, and adenovirus.

Bacteria infection causes a mean of two of every ten cases of gastroenteritis. Throughout the globe, the three most important are Salmonella, Shigella, and Campylobacter. Generally, bacteria can harm in two ways, one with direct invasion of the intestinal lining and others indirectly by toxins. Despite both ways ends in the intestine inflammation, hence, gastroenteritis. The bacteria that enter the intestinal lining, invading it, cause the worst disease scenario, including symptoms and complications.

How does gastroenteritis spread?

Viral gastroenteritis, which is principally by norovirus spreads in general through a direct contact fashion. The vulnerable people would be the ones attending others that have the virus, sharing food, or any other source where the virus could remain as surfaces or water. In numerous facilities, people are susceptible without the right measures of undergoing a gastroenteritis outbreak as healthcare facilities, restaurants, schools, and cruise ships.

For the bacteria is the same story; however, in this case, I can be a little more specific. There is transmission by direct contact, but the one coming from contaminated food is significant. For example, S. aureus grows well in meat, eggs, and salad. Enterohemorrhagic E coli can exist in undercooked animal food, contaminated water, or raw milk. Salmonella spread is through undercooked eggs or meat, ice cream, raw milk, fruits, and vegetables. And, Campylobacter by handling or eating undercooked poultry, raw milk, or cheese. Every viable bacteria could have its particular route, so there are many more, but those are the most important.

What are the risk factors for gastroenteritis?

Gastroenteritis is rarely a motive of severe disease, albeit you have any of these risk factors. There could be two significant circumstances, one in an association with the people and the other with harmful microorganisms.

For example, no matter what microorganism is causing the infection, it could be severe if the person has a risk factor. The list comprises having a weakened immune system (diabetes, the elderly, children, or cancer) or underlying chronic disease that impossibilities the body to fight the microbe correctly. Also, there are predisposing factors that source the infection by harmful bacteria as a recent course of antibiotics or hospitalization.

Similarly, if a healthy person gets an infection by a very harmful bacteria, he or she will experience an intractable disease, despite their robust immune system. This situation is often true for bacterial infections, and their major symptoms are fever and bloody stool.

How do people get viral gastroenteritis?

Mostly by direct contact with persons that has the virus. Also, by manipulation or consumption of contaminated food or water, containing either viruses, bacteria, or parasites. Please read how gastroenteritis spread above, to find out more.

How does food get contaminated by gastroenteritis viruses?

Mostly through an unsanitized manipulation of the food by people that have the virus. Or someone previously manipulated whatever object or element with the virus and then touched the food.

What are the symptoms of acute gastroenteritis?

Gastroenteritis can extend from no symptoms to a mild, moderate, and severe presentation, which includes death. The symptoms would differ if it is acute viral gastroenteritis, or there is a bacterial infection that can cause severe symptoms. Likewise, the parasites have variable symptoms, with some producing mild and other agonizing conditions.

Viral gastroenteritis presents with classic symptoms as mild fever, vomits, and self-limited nonbloody diarrhea. In light of this, the viral source would remain as the probable cause if none of these severe symptoms appear: excessive fever, intolerable abdominal cramps, more than six defecations within 24 hours, and bloody diarrhea.

You may want to see: Acute Diarrhea

Bacterial gastroenteritis tends to be more severe. It depends on which bacterium is causing the infection. The patient would have vomits, nausea, high fever, bloody stool, and mucus in the stool. All the invasive bacteria can cause blood in the stool, such as E. coli, Shigella, Salmonella, Campylobacter, Yersinia, Clostridium difficile, and Aeromonas species; from the parasites the Entamoeba histolytica.

The noninfectious cause of gastroenteritis can produce severe gastroenteritis as inflammatory bowel disease. This condition could express either as a Crohn disease or ulcerative colitis, and it induces severe inflammatory diarrhea with other incapacitating general symptoms.

How long does this condition last?

Usually, the duration of infectious gastroenteritis is not more than seven days. Many of them cease symptoms even earlier, with a mean of two to three days, for the mild cases. However, moderate or severe circumstances could last longer, even more, if complications arise. Therefore, the diseases lasting more than seven days should undergo a thorough assessment by your doctor, either for determining the infectious cause or a possible inflammatory disease.

What are the complications of gastroenteritis?

The main complication of gastroenteritis is dehydration. Because of the vast amount of fluid lost through diarrhea, it is no surprise that a person dehydrates and even more the vulnerable population as the children or the elderly.

This complication is so crucial that classification in mild, moderate, and severe, based on its symptoms, exist, and it necessary to be aware of it; many lives could be saved. The symptoms are the absence of teardrops, dry mouth, lack of thirst, or dipped eyes. For illustrating to you how serious it is, rotavirus alone causes half of million deaths worldwide annually.

Many other complications exist, and they are in more association with bacteria and parasites as a source of the infection. The list includes chronic diarrhea, organ failure, bacteremia, severe hypotension, bowel perforation, and more.

How is bacterial gastroenteritis diagnosed?

Typically your doctor would start by asking an abrupt or gradual onset of the symptoms, in case of foodborne how many hours after passed after eating before symptoms onset. The characteristics of the stool are essential, mainly the color, if it is watery or contain mucus or blood—frequency and quantity of bowel movements, and any other symptom as fever or abdominal cramps. The risk factors are also a standard question, recent travels abroad or antibiotic use, and any history of consuming raw food. This interrogation would lead your doctor to think in a mild or more severe condition.

Then there is the whole-body examination of the patient; it talks about any sign of dehydration or organ harm that is also useful for the doctor. Nevertheless, for diagnosing this disease, the stool analysis in all its aspects is the cornerstone because it allows the doctor to differentiate between a mild (viral) or severe (bacterial) expression of gastroenteritis. Though a simple stool sample, a doctor could infer, and either start treatment or not, or ask for more specialized exams as the bacterial culture. The two determinants found in stool analysis are fecal leukocytes and occult blood. They suggest an inflammatory or severe condition, although not giving any definitive diagnosis.

The bacterial culture exam does not always show positive results; indeed, its rate is shallow. However, when positive, it is beneficial because it identifies the harmful bacteria and tells your doctor which antibiotic would be effective against it.

How are the other gastroenteritis diagnosed?

The largest proportion of viral infections would not require any diagnose at all. However, in some cases, it becomes mandatory. Most of the time, viral gastroenteritis is “diagnosed” by just discarding a bacterial source of infection. However, immunologic exams exist for rotavirus, and by molecular techniques, tests for calicivirus. Yes, they are there, although oddly, are needed.

Special exams exist for parasites, even though they are no as common as viruses and bacteria cause a relevant percentage of the disease. They are usually left behind except for cases of traveling abroad where parasites are more prevalent. It is generally done by taking three stool samples, each day, for three consecutive days. These measures are for maximizing the chances of finding the parasites in the stool, which tend to be elusive to the microscope.

Diagnosing a patient with gastroenteritis in a vast majority of the cases is not necessary, but if it does, as you saw, is in a stepwise fashion. From the most common to the least common, unless a risk factor tells otherwise.

How is bacterial gastroenteritis treated?

After a thorough assessment of the patient with gastroenteritis, and evidence, it has bacteria, starting antibiotic treatment is an indication. Nonetheless, please remember that people with a viral infection do not benefit from antibiotics, only from rehydration or symptom-relief therapy. So do not use antibiotics unless your doctor tells you to do so. Also, discerning between bacteria and parasites is crucial because each one needs specific antimicrobial therapy besides standard care treatment.

The standard antibiotic treatment has various scenarios in which could be used. Patients experiencing more than eight defecations per day, dehydration, symptoms lasting more than seven days, patients with fever and bloody stools, or people with a weakened immune system, all of them would highly benefit from a course of antibiotics.

An empiric treatment means that a doctor uses an antibiotic without knowing as a fact what microorganism is involved. However, the therapy is designed to cover the most frequent bacteria in the disease. If, later on, on the course of the illness, a microbiological exam yields a specific bacteria, then the treatment could change towards that particular microbe. The quinolones and azithromycin are both antibiotics commonly used.

Can this condition be prevented?

It is possible to prevent it with thoughtful, albeit easy to perform measures. The list of prevention measures includes washing your hands often, eat food you know its preparation concur with the hygiene standards, avoid consuming not sanitized water. For the travelers, there is a rule that says, “boil it, cook it, peel it, or forget it.”

For some of those infections, there are available vaccines that help to prevent the illness or their severeness. The rotavirus vaccine and Salmonella typhi vaccine have proved to be effective worldwide.

What is a traveler’s diarrhea?

Traveler’s diarrhea is diarrhea that begins when traveling abroad and consuming contaminated water or food from the other country. Despite the symptoms being very bothersome, it is usually a mild disease that would pass within a few days.

This type of diarrhea represents a global problem with a significant impact on the financial and healthcare system of both countries. Even though through worldwide sanitation measures, it has lowered within the years, it continues to be a problem of these days, appearing annually as a cause of disease.

Nevertheless, current studies show that the cause of traveler’s diarrhea is mainly by a bacterial infection. So scientific efforts towards this ailment focus on defining treatment that eliminates specific bacteria to diminish symptoms length or possible complications.

This condition can receive either preventive or actual treatment. Prophylactic or preventative treatment should not be used unless a patient has a high risk of developing complications of this disease. The prevention could be with BSS, and if it is going to be an antibiotic, rifaximin.

What can I do If I have symptoms of it?

Luckily for you, this tool is a gastroenteritis symptoms checker, which would help you to determine. How likely is that your symptoms are by gastroenteritis. Please, feel free to use it as much as you want. It would only take a few minutes, and it is free.

What do you think?

Written by Dr. Esteban Kosak

Doctor of Medicine - MD Recently Graduated from Medical School and inspired to aid the global population during this situation. I think that we shall no longer be waiting to see a doctor when we feel sick. Several times we feel disease searches in Google drive us to a rabbit hole and come out thinking that we may die of cancer or something very serious, given that symptoms may seem to fit a wide variety of illnesses. Since I recently graduated from medical school. I have all the medical information fresh in my mind. My thorough experience as an expert researcher allows me to very-well known the different diseases and conditions that affect human bodies. Empowered by the United Nations 17 Sustainable Development Goals (SGDs). I think that we all can provide a grain of sand to help humanity. That's why we created Symptoms.Care a place where you can come and screen your symptoms and find what different illnesses can be related to them. Armed with the right information you can instantly, discretely, secure and from the comfort of your home talk with a Doctor that can Evaluate your Symptoms and help you seek the right treatment.


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